Cognitive Enhancement Therapy for Autism

(PerspectivesII Trial)

Age: < 65

Sex: Any

Trial Phase: Academic

Sponsor: University of Pittsburgh

Disqualifiers: Organic brain syndrome, Untreated ADHD, Personality disorder, others

No Placebo Group All trial participants will receive the active study treatment (no placebo)

Compensation: Varies

Number of Visits: Unknown

Duration: 18 months

86 Participants Needed

Trial Summary

What is the purpose of this trial?

This trial will test two therapies for adults with autism. One therapy aims to improve thinking and planning through mental exercises. The other provides support to help manage emotions and social skills. The study focuses on adults because there are few treatments available for them.

Will I have to stop taking my current medications?

The trial information does not specify whether you need to stop taking your current medications. It might be best to discuss this with the trial coordinators.

What data supports the effectiveness of the treatment Cognitive Enhancement Therapy for Autism?

Cognitive Enhancement Therapy (CET) has shown benefits in improving thinking skills and social functioning in people with schizophrenia, suggesting it might help with similar challenges in autism. Studies have found that CET can enhance cognitive and social abilities, which are often areas of difficulty for individuals with autism. ^{1 2 3 4 5}

Is Cognitive Enhancement Therapy safe for adults with autism?

Cognitive Enhancement Therapy (CET) has been studied in adults with autism and was found to be satisfying to participants, with high treatment attendance and retention, suggesting it is generally safe and well-tolerated. ^{6 7 8 9 10}

How is Cognitive Enhancement Therapy for Autism different from other treatments?

Cognitive Enhancement Therapy (CET) is unique because it combines supportive therapy with social skills and cognitive training to improve thinking and social abilities, originally developed for schizophrenia. It focuses on enhancing cognitive functions and social interactions through group exercises and interactive software, which may offer a novel approach for autism compared to traditional therapies. ^{1 2 4 5 11}

Research Team

Nancy J Minshew, Ph.D.

Principal Investigator

University of Pittsburgh

Shaun M Eack, Ph.D.

Principal Investigator

University of Pittsburgh

Eligibility Criteria

Adults aged 16-45 with autism, Asperger's syndrome, or pervasive developmental disorder not otherwise specified (NOS), who have an IQ over 80 and significant social/cognitive challenges. Participants must speak English fluently, be able to attend sessions in Pittsburgh, PA, and have a supportive person for information sharing.

Inclusion Criteria

Ability to read and speak fluent English

I am between 16 and 45 years old.

I can go to weekly treatment sessions in Pittsburgh, PA.

Exclusion Criteria

Organic brain syndrome

History of disruptive or violent behavior

I have ADHD that has not been treated.

Timeline

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Treatment

Participants receive either Cognitive Enhancement Therapy (CET) or Enriched Supportive Therapy (EST) for 18 months

18 months

Weekly visits (in-person)

Follow-up

Participants are monitored for the lasting impact of the study interventions

12 months

Periodic assessments (in-person)

Treatment Details

Interventions

• Cognitive Enhancement Therapy
• Enriched Supportive Therapy

Trial Overview The trial is testing Cognitive Enhancement Therapy (CET) against Enriched Supportive Therapy (EST). CET focuses on improving thinking and social skills while EST helps with understanding the condition, managing emotions/stress, enhancing social abilities, and problem-solving.

Participant Groups

Group I: Cognitive Enhancement Therapy Experimental Treatment 1 Intervention

This research treatment aims to help with problems in thinking, planning, and socialization. Participants begin with cognitive training using computer software programs. They also participate in a small social-cognitive group to learn about their condition and how to act wisely in social situations by developing the abilities needed to understand another person's perspective, evaluate social contexts, and be foresightful. Time commitment: about 3½ hours per week; Location: Pittsburgh, PA only

Group II: Enriched Supportive Therapy Active Control 1 Intervention

This research treatment uses individual supportive therapy to help adults learn about autism spectrum disorder, manage their emotions and stress, improve their social skills, and cope with everyday problems. Participants will learn about the impact of stress on their lives, and how to identify their own early cues of distress and apply effective coping strategies. Time commitment: about 1 hour per week; Location: Pittsburgh, PA only

Who Is Running the Clinical Trial?

University of Pittsburgh

Lead Sponsor

Trials

1,820

Recruited

16,360,000+

National Institute of Mental Health (NIMH)

Collaborator

Trials

3,007

Recruited

2,852,000+

Findings from Research

Cognitive Enhancement Therapy (CET) aims to improve social cognition in schizophrenia patients by using interactive software and group exercises, focusing on abstract thinking and social context understanding.

Preliminary observations suggest that CET effectively addresses cognitive deficits related to social interactions, potentially helping patients manage symptoms of schizophrenia more effectively.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Practice principles of cognitive enhancement therapy for schizophrenia. Hogarty, GE., Flesher, S.[2019]

Cognitive Enhancement Therapy (CET) showed sustained improvements in cognitive and social functioning one year after treatment in individuals with schizophrenia, based on a study of 121 participants.

Early improvements in processing speed were identified as a key factor mediating the long-term benefits of CET on social cognition and adjustment, suggesting that enhancing this cognitive aspect may be crucial for ongoing therapeutic effects.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Durability and mechanism of effects of cognitive enhancement therapy. Hogarty, GE., Greenwald, DP., Eack, SM.[2019]

Cognitive enhancement therapy (CET) significantly improved overall cognition in patients with early-course schizophrenia over an 18-month period, as confirmed by a study involving 102 outpatients.

While CET showed promising effects on social cognition and attention, it did not significantly outperform enriched supportive therapy (EST) in improving social adjustment, although the benefits appeared to increase for those who completed the treatment.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Confirmatory Efficacy of Cognitive Enhancement Therapy for Early Schizophrenia: Results From a Multisite Randomized Trial. Wojtalik, JA., Mesholam-Gately, RI., Hogarty, SS., et al.[2023]

Cognitive Remediation Therapy (CRT) significantly improved executive functions and school performance in children and adolescents with Autism Spectrum Disorder (ASD), with 16 out of 25 participants completing an average of 22 sessions.

After CRT, participants showed notable enhancements in intellectual abilities, working memory, and specific aspects of cognitive flexibility, indicating that CRT is a promising intervention for addressing cognitive impairments associated with ASD.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Cognitive remediation therapy in autism spectrum disorder: Tunisian experience. Hajri, M., Abbes, Z., Ben Yahia, H., et al.[2020]

Cognitive remediation therapy (CRT) has shown cognitive performance improvements in patients with eating disorders, regardless of their level of autistic characteristics, indicating its broad applicability.

This preliminary study supports the feasibility and benefits of individual CRT for patients exhibiting features of autism spectrum disorder, suggesting it can enhance cognitive functioning in this population.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Individual cognitive remediation therapy benefits for patients with anorexia nervosa and high autistic features. Dandil, Y., Smith, K., Adamson, J., et al.[2022]

Cognitive enhancement therapy (CET) for first-episode schizophrenia effectively combines supportive therapy with social skills and cognitive training, aiming to improve cognitive and negative symptoms in a motivational format.

The therapy emphasizes a strong therapeutic alliance, allowing clinicians to use techniques like errorless learning and positive reinforcement, making it adaptable for both group and individual treatment settings.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Cognitive enhancement therapy: a therapeutic treatment strategy for first-episode schizophrenia patients. Miller, R., Mason, SE.[2019]

References

1. Netherlands pubmed.ncbi.nlm.nih.gov

Adapting cognitive remediation to a group home: A brief report. [2017]

2. United States pubmed.ncbi.nlm.nih.gov

Practice principles of cognitive enhancement therapy for schizophrenia. [2019]

3. United States pubmed.ncbi.nlm.nih.gov

Durability and mechanism of effects of cognitive enhancement therapy. [2019]

4. United States pubmed.ncbi.nlm.nih.gov

Confirmatory Efficacy of Cognitive Enhancement Therapy for Early Schizophrenia: Results From a Multisite Randomized Trial. [2023]

5. Netherlands pubmed.ncbi.nlm.nih.gov

Neurocognitive enhancement therapy with vocational services: work outcomes at two-year follow-up. [2022]

6. United States pubmed.ncbi.nlm.nih.gov

Cognitive enhancement therapy for adults with autism spectrum disorder: results of an 18-month feasibility study. [2022]

7. United States pubmed.ncbi.nlm.nih.gov

Cognitive enhancement therapy for adult autism spectrum disorder: Results of an 18-month randomized clinical trial. [2019]

8. United States pubmed.ncbi.nlm.nih.gov

Brief report: is cognitive rehabilitation needed in verbal adults with autism? Insights from initial enrollment in a trial of cognitive enhancement therapy. [2021]

9. Tunisia pubmed.ncbi.nlm.nih.gov

Cognitive remediation therapy in autism spectrum disorder: Tunisian experience. [2020]

10. England pubmed.ncbi.nlm.nih.gov

Individual cognitive remediation therapy benefits for patients with anorexia nervosa and high autistic features. [2022]

11. United States pubmed.ncbi.nlm.nih.gov

Cognitive enhancement therapy: a therapeutic treatment strategy for first-episode schizophrenia patients. [2019]